Saturday, August 31, 2013

You will notice this is the seventh article in this series. Now that we have talked about all of the things that can hurt you, we are now going to talk about the foods that you should be able to eat. Some of the foods that seldom cause negative reactions are salmon and lamb. Later I will talk about another book by a doctor and he says no meat or fish. Again everyone is different and you will have to see what works for you. My wife has found that any animal that is range fed, such as some longhorn beef, bison, and other wild game that eat grass only are OK for her. It takes some getting used to the lack of fat in these meats, so you add either olive oil or safflower oil when cooking. Who doesn't need less fat and red meat in their diet anyway. But she only eats them occasionally, and when she starts feeling bad, she goes back to more vegetables and less meat, even completely eliminating meat completely for a few days.

Other foods that are "safe" for most are honey, sea salt, and olive oil. It may take a while to get used to these and stop using the oils, sweeteners and salt you have been used to having. But remember the ultimate goal, we want to find what is causing the pain and inflammation. Most people know these are better for all of us anyway. My wife uses these for seasoning and sweetening. Some fruits on this list are grapes, apricots, peaches, cranberries, and plums. Vegetables on this list include sweet potatoes, yams, squash, beets, and cauliflower. Different sources will list different foods on these lists. Ms. Allan listed dried beans as a food that often causes pain and yet my wife eats them every day as a major part of her diet. Her lunch nearly every day is boiled cabbage and one of the many dried beans. I wish I could give you a definitive list that would work for you. You can not go by what you have eaten in the past, unless a food has caused you problems in the past. A good example from my wife was eating Chinese from a place we have eaten three to four times a month for twenty years. After she developed R.A. she was eating the same hot and sour soup that she ate every time she felt a cold coming on. But this time she could feel the pain in her legs as soon as she started eating it. I had to help her up the stairs that night. As I said before, it usually takes much longer for your body to react.

Foods frequently blamed for food allergies and sensitivity reactions are also believed to cause or contribute to inflammatory and autoimmune conditions. These common foods are likely doing so through a process of gut inflammation resulting in leaky gut. This injury, especially occurring in genetically predisposed people, and in the setting of altered gut bacteria (dysbiosis), and immune stress likely predisposes to further inflammation and leaky gut. This vicious cycle is thought to allow toxic food protein-bacteria complexes to enter the body resulting in a variety of inflammatory and/or autoimmune conditions such as rheumatoid arthritis. A new study sheds some additional light on link of food intolerance to rheumatoid arthritis is reviewed in this context.

Researchers from Norway in 2006 published in the British journal Gut additional new evidence of the link between foods and rheumatoid arthritis. Professor Bradtzaeg and his colleagues at the Institute of Pathology in Oslo measured IgG, IgA, and IgM antibodies to foods. The measured these antibodies in blood and intestinal fluid in people with rheumatoid arthritis compared with healthy people.

The researchers performed blood and intestinal fluid antibody tests to the following food antigens: gliadin, oats, cow's milk proteins (casein, lactalbumin, lactoglobulin), soy, pork, cod fish, and egg (ovalbumin). These foods are in the top 10 of common food allergens as well as food protein intolerances.

What they found was a "particularly striking (incidence) of cross reactive food antibodies in proximal gut secretions" as well as increased IgM antibodies to some of these foods in the blood. The findings in the blood were less striking than in the intestinal secretions. This is consistent with difficulties finding elevated blood antibodies to foods in people with rheumatoid arthritis and other autoimmune/inflammatory conditions despite a lot of anecdotal and elimination diet experience supporting the role of foods in these conditions. Interestingly, Dr. Ken Fine's stool antibodies tests may be on to something.

The results, in their opinion, indicate that measuring blood antibodies to foods in rheumatoid arthritis provides little information about the role of foods in rheumatoid arthritis. However, intestinal antibodies not only show a "striking" pattern of elevation consistent with adverse food immune reactions but also that there appears to be a potential cumulative effect of multiple foods. That is, not only may some foods trigger an abnormal immune response resulting in joint inflammation but the combination of multiple problem foods may be a key component to this link. Their results support the connection of mucosal (gut) immune activation from cross reaction of foods to rheumatoid arthritis in at least some people.

What might this mean? This data supports the concept and the experience of many people that elimination of certain problem food combinations may be beneficial in preventing or reducing joint inflammation. This is both exciting and intriguing.

Multiple commonly eaten foods frequently linked to food allergies and sensitivities may be contributing to inflammatory and/or autoimmune conditions. These common problem foods or their lectins are likely contributing to the process of gut inflammation. This is likely causing gut injury resulting in leaky gut. This injury and leaky gut, especially in genetically predisposed people, may, in the setting of altered gut bacteria (dysbiosis), predispose to further injury. This then allows the entry of toxic food protein (lectin)-bacteria complexes into the body, especially the blood stream. The result is inflammatory and/or autoimmune conditions like rheumatoid arthritis.

This gut-joint axis is likely the same mechanism as the gut-brain axis and gut-skin axis that produce the myriad of symptoms and diseases we are now seeing. The associated food protein (lectin)-bacteria immune reactions in the gut are increasingly being blamed for the development of a myriad of diseases.

Much more needs to learned, but it is interesting that certain foods keep showing up as the usual suspects. These problem foods or lectins include the grains (especially wheat, barley, rye, oats, corn), dairy (casein), nightshades (potato, tomato, peppers) and peanuts, soy and other legumes. Diets eliminating or restricting these foods have been reported as being beneficial for many symptoms and diseases. However, definitive links are difficult to establish because of limitations of scientific research.

The foods implicated are usually limited in some manner in a variety of elimination diets such as the gluten-free/casein free diet, naked diet, paleolithic/hunter-gatherer or caveman diets, arthritis diet, low carbohydrate diet, anti-inflammatory diet, and six food elimination diet.

The Paleolithic or Hunter-Gatherer diet specifically recommends restricting grains, dairy and legumes. Various anti-inflammatory or arthritis diets usually recommend eliminating either wheat or gluten, dairy and the nightshades. The dietary approach to autism commonly advocated is a casein-free, gluten-free diet.

Despite lay public reports of great successes with such elimination diets, mainstream medicine continues to be slow to study the dietary treatment of disease. However, especially in the past two to three years more studies are appearing showing links supporting a significant role of food and bacteria in the gut and various autoimmune diseases.

A rheumatoid arthritis natural remedy works by treating the cause and rebuilding the joint with natural supplements. The cause of Rheumatoid arthritis has been identified many years ago and successfully treated using a simple antibiotic. However while doctors continue to debate this treatment, everyday people continue to suffer.

According to naturopath, physician, health and longevity expert and veterinarian Dr Joel Wallach in his book, 'Let's Play Doctor', "This disease has been recognized and eliminated by the veterinary industry".

Dr Wallach contends that the cause of the disease isn't a problem with your immune system - it's caused by a foreign organism such as a bacteria or a virus attacking the joint capsule membrane and the tendon sheaths of the fingers and toes. And this then triggers the normal immune system response which involves inflammation, heat around the joint, sickness and fever. To first begin treating the infection - most likely a pleuro-pneumonia or similar organism that causes upper respiratory infection and pneumonitis - you need to discuss options with your health care professional. One suggestion is an older antibiotic such as minocycline as it has few side-affects than its modern counterparts.

You should discuss minocycline treatment with your health care practitioner - and if they're not interested, then you can always go an get another opinion.

The facts are that a significant number of people in a number of scientific studies have shown improvement during and after treatment with minocycline - one this is one treatment option you shouldn't ignore just because your doctor has never heard of it.

The process of rebuilding the joint and providing a rheumatoid arthritis natural remedy involves supplementation with the building blocks of the bone, joint and joint capsule.

The addition of specific supplements that support healthy bones & joints such as glucosamine/chondroitin and a natural pain relief remedy will also assist.

One other thing to consider in any rheumatoid arthritis natural remedy - especially if you are taking some type of antibiotic to treat the infection - is that you need to make sure that your 'gut flora' - the good bacteria that help you break down and absorb nutrients - are healthy. This will also maximize the effectiveness of the supplement nutrients.

In this case it is recommended that you consume foods that are high in these organisms - such as natural yoghurt with acidophilus or take a supplement that contains high amounts of this 'good bacteria'.

The use of a digestive enzyme product will also assist the absorption of the nutrients in the supplements and from food and may greatly assist relief and recovery.

Here's a summary of the things we've covered in this article:

1. A rheumatoid arthritis natural remedy is achieved by treating the likely cause - most likely a bacterial infection - with a safe antibiotic such as minocycline

2. Supplementing with the 90 essential nutrients, glucosamine, chondroitin and CM will help the body rebuild the joint as well as provide pain relief and reduce the inflammation

3. Consider the use of digestive enzymes to improve absorption of the nutrients

Arthritis causes health problems and disabilities in nearly 70 million Americans, or about one in every three adults, and the numbers are only on the rise. Arthritis symptoms can vary from mild to severe, sometimes even leading to disability. Approximately 17% of disability cases are caused by arthritis, resulting in enormous costs for the individual, their families, and the state.

Arthritis is not a disease but a group of diseases whose common denominator is inflammation, stiffness, limited movement, pain, and destruction of the joints. Three out of 5 arthritis sufferers are under the age of 65, so arthritis is not just a disease of the elderly.

The most common form is Osteoarthritis, which is also known as wear and tear arthritis". It is commonly thought of as by product of the aging process like gray hair, and wrinkles. Osteoarthritis starts usually in the middle age, long before the first symptoms are noticed. The cartilage that covers the bone starts to deteriorate, allowing bones to rub together. Bone spurs and cysts are common developments. During this degeneration process the muscles, tendons and ligaments may become strained, causing inflammation and pain. The main problem with Osteoarthritis is pain; inflammation is a problem in the later stages of arthritis. Sometimes there is no pain, but the affected joints loose range of motion and become stiff.

Osteoarthritis appears in two general forms, primary and secondary. Primary osteoarthritis is the more common form, is a slow and progressive condition that usually strikes after the age of 45, affecting mostly the weight bearing joints of the knees and hips, as well as the lower back, neck, large toe and finger joints. It develops through placing excessive loads on a joint or when a reasonable load is placed on an inferior joint. The exact cause is yet to be determined, although heredity and obesity are risk factors.

Secondary osteoarthritis appears usually as a result of trauma or injury to the joint (like a football injury or car accident), metabolic imbalances (gout or calcium deposits, iron overload, thyroid disease, or long term use of certain medications), joint infection, or even surgery. It strikes people younger than 45. Trauma appears to be the main reason for developing osteoarthritis. The trauma could be acute (accident) or chronic (recurring over time). Chronic trauma causes cumulative damage to the joint. The onset is usually felt as a little discomfort that becomes severe and debilitating over time. An unstable or loose joint because of a torn ligament would be an example of this. Repetitive impact loading is another form of chronic trauma. This involves a repetitive motion that traumatizes the joint tissue (baseball pitcher, drill operator, ballerina). Repetitive impact loading is one of the main causes of secondary osteoarthritis, especially in joints that are already suffering from abnormal alignment or that are used in ways that they shouldn't be. Not all-high stress activity damages joint tissues, most of them can. Osteoarthritis might also be the cause because of poor bone alignment, improperly formed joints, or they way you walk.

Osteoarthritis and Rheumatoid arthritis are often confused because of the similarity in their names. Rheumatoid arthritis is an autoimmune disease that causes the body's immune system to attack its own tissues. It causes weakness, fatigue, fever, anemia, and other problems, including inflamed joints. Rheumatoid arthritis tends to strikes symmetrically, meaning it strikes both joints (left and right side of the body). It initially strikes between the ages of 25 and 50, versus Osteoarthritis usually after 45. RA often comes and goes without warning; OA develops gradually over several years. OA begins in one joint. RA symptoms are redness, warmth, and swelling, in OA these symptoms are unusual in the early stages. RA affects many or most joints like knees, knuckles, wrists, elbows, and shoulders. OA primarily affects joints of the hands, hips, feet and spine, only occasionally attacks other joints. RA causes an overall feeling of sickness and fatigue, as well as weight loss and fever; OA doesn't cause an overall feeling of sickness.

It is the common consensus that arthritis is incurable, and can only be managed with pain and anti-inflammatory medication. This treatment plan will only mask the symptoms and will not address the underlying causes, so the disease can progress further. Also these drugs have serious side effects. Thousands of people die every year from adverse side effects of anti-inflammatory, acetaminophen, and steroids.

Healthy cartilage needs 3 things; water for lubrication and nourishment, proteoglycans to attract and hold the water, and collagen to keep the proteoglycans in place.

There are alternative treatment plans available to can be of great help to the arthritis sufferer.

Food Link to arthritis, food allergies and intolerances could aggravate and cause arthritis. Keeping your body at an ideal weight, and supplying your body with all the nutrients it needs to rebuild muscle and bone tissue is important. Eating an alkalizing diet that includes fresh fruits and vegetables, lean protein and complex carbohydrates, and cutting back on sugar and bad fats. Arthritis is a disease of an over acidic system. Practicing portion control and developing good eating habits will help you loose weight and maintain it, while feeling better and more energetic. Limit your purine intake, purines are found in organ meats, anchovies, and sardines. Excess purine levels in the blood lead to uric acid, which has been linked to Gout and arthritis. Alcohol increases also increases uric acid production. Intake of refined sugar has a negative impact on blood sugar balance, the immune system, and promotes inflammation. The family of nightshade of vegetables, like tomatoes, eggplants, potatoes, and peppers are the most common culprits to cause an arthritic condition.

Increasing your water intake can be of great help. Many chronic health conditions are caused by chronic dehydration. You can eliminate many problems by just drinking more water.

Supplementations can be of great benefit, if the right dosages and the right product are used. This will determine if the supplementation will be effective. The three most promising supplements for arthritis suffers are Glucosamine, chondroitin, and ASU.

Glucosamine consists of glucose and the amino acid glutamine. It is an important part of the mucopolysaccharides, which provide structure to the bone, cartilage, skin, nails, hair, and other body tissue. Glucosamine is a major building block of the proteogylycans.

The recommended dosage for Glucosamine HCL it is 1500 mg, or 1884 mg for Glucosamine sulfate once daily or twice divided into two equal doses. Glucosamine sulfate is the form used in most research. Glucosamine HCL is somewhat preferred, because Glucosamine sulfate needs to be stabilized with salt or potassium. This could lead to an unwanted rise in blood pressure, depending how much salt or potassium was added.

Chondroitin works similar to the natural occurring chondroitin in the body's cartilage, it protects the old cartilage from premature breakdown and stimulates the synthesis of new cartilage.

The recommended dosage for Chondroitin is 800 to 1200 mg once daily or twice divided into 2 equal doses.

Glucosamine and Chondroitin taking together is preferred, because the work synergistically. They stimulate synthesis of new cartilage, while simultaneously controlling the cartilage destroying enzymes, and keeping the chondrocytes healthy. These supplements treating the disease on a cellular level, helping the body heal itself. While pain medications only mask the symptoms of the disease.

ASU is a natural vegetable extract made from Avocado and Soybean oils. Avocado Soybean Unsaponifables has been a prescription treatment for osteoarthritis in France since the early 1990s. ASU differs from Glucosamine and Chondroitin, because it is a mixture of many different plant substances. ASU comes from the natural avocado and soybean oils; the supplements ratio is one part avocado to 2 parts soybean. The processing of ASU is very complex and expensive. ASU is even more complicated than making Glucosamine and Chondroitin. There are multiple active ingredients in ASU that need very careful handling to be purified and stabilized. Some companies are selling avocado and soy oils, and not the active ASU ingredients. Avocado and Soy oils do not contain the same active components, in the same quantities, as the highly processed, purified, and concentrated ingredients as in the valid products.

Recommended dosage for ASU is 300 mg once daily.

When buying any supplement, you have to make sure that it is of good quality. One way to ensure this is to buy products that adhere to Good Manufacturing Protocols. The box should have GMP stamped on it. The product could be inferior even if the label states that it is "laboratory tested". This could only refer to the raw material, which is really inconclusive, and many things can happen in the process of making a supplement. Only testing of the end product is an acceptable form of assuring accurate readings. Taking inferior products, ones that don't use quality ingredients, or products that are not manufactured with the proper controls, is simply a waste of time and money. Unfortunately this is the case with most products on the market today.

Chondroitin is more expensive to manufacture than Glucosamine. As a result companies are more interest in profit than quality may try to skimp on chondroitin by providing less than is listed on the label; using dosages lower than those supported by research; substituting cheaper, less active, or inactive substances; obtaining chondroitin from companies that don't follow the strictest quality standards in processing.

All three products are general safe. Glucosamine is safe for diabetics; it delivers the same of sugar as a grape. The majority of Glucosamine is manufactured from the shells of lobsters, shrimp and crab. The meat protein that causes the allergic reaction is not found in the shell. People with shellfish allergy should be careful and ask their doctor, or take Regenasure, the vegetarian form. There are no reports on adverse reactions. There is no evidence to support the danger contracting mad cows disease from Chondroitin. The bacteria would be killed during processing.

Be aware of products that claim to be long lasting, time-released or control delivery. Glucosamine, Chondroitin and ASU are long lasting themselves. Also for best results, you want them to be released as quickly as possible.

Double and triple strength products indicate that you need to take fewer tablets to achieve the same results. This basically means larger tablets, which is not a good idea for somebody that has a problem swallowing.

Liquid supplements are usually not as stable as powders or capsules. There is no evidence that liquid absorbs better than capsules, in this particular case. It is possible that absorption is lower in liquid products. Stomach acid is important for proper absorption of glucosamine. The liquid products could dilute the acid, interfering with absorption. There is also a problem with poor taste, and drinking more water to mask it, again diluting the product.

Be cautious of the word complex in Glucosamine/Chondroitin products. It generally means that other substances have been added, like manganese or

Vitamin C. It could also mean that the product was diluted with N-acetylglucosamine. This could lead to a reduced effectiveness of the potency. Chondroitin complex usually means that inferior products are used, like MSM, hydrolyzed collagen, chicken cartilage, and related substances that are not Chondroitin. This reduces cost and brings more profit for the manufacturer, but hurts the consumer by providing them with an ineffective product.

Use caution if there is a money back guarantee. Most manufacturers make their money with shipping alone.

Be cautious if something claims to be better than Glucosamine and Chondroitin, with the exception of ASU, there is nothing to support this claim scientifically.

Avoid store brands. The FDA does not strictly regulate dietary supplements. There is no such thing as a "generic" supplement - there are only good or poor supplements. You are probably not getting the active ingredients you need in a store brand.

Product quality remains as the most important barrier in using glucosamine/chondroitin and ASU supplements. When buying these products make sure to buy from a company that follows good manufacturing practices; buy products that have also been tested and recommended by independent laboratories.

Exercise and Rest: You have to move to stay healthy. Exercise helps with circulation, venous and lymph return, waste elimination, tones your muscles and internal organs, and your joints. The cartilage in your joints has no blood supply, and depends on moving them to nourish them and remove waste products. Weight bearing exercise helps to keep your bones strong, and to prevent Osteoporosis. Yoga and stretching improves flexibility and lengthen muscles. Cardio exercises improve circulation and waste elimination. Exercise in itself releases feel good hormones in the body, and is beneficial for depression and mental well-being.

It is important to get proper rest at night, so the body has a chance to recharge itself. Not giving your body a chance to rejuvenate will leave you feeling empty and depleted.

Meditation and Relaxation: There is a link between stress and chronic health conditions. The more you focus on something, the bigger it will become. If you are in constant pain, you will focus on it and it will become your state of mind. This is understandable, but it will only bring you more pain. Learning relaxation methods like meditation, biofeedback, visualization among others, will help you release negative stress, and feel better.

Acupuncture and Chinese Medicine: see health not only as an absence of disease, but as a harmonious state of body, mind and spirit. In Chinese medicine your health is determined by your ability to balance your yin and yang, the two opposing forces that make up everything in the universe. The vital energy of the body or qi is interrupted when yin and yang are out of balance, resulting in pain and disease. Establishing balance and harmony in the body will result in health.

Ayurvedic: Ayurveda means "knowledge of life." It represents a complete philosophy of life and living. The client is guided on how to develop self-knowledge and learn how to correct imbalances to obtain health. The client will work on strengthening their prana (life force) by harmonizing their dosha or constitutional type. The treatments involve diet and nutrition, herbs, yoga exercises, meditation, massage, and breathing exercises.

Chiropractic and Osteopathy: both modalities aim to bring the body back into alignment by adjusting the bones of the body. The nervous system is brought back into proper working order by restoring proper balance to the spinal column and joints, allowing nerve impulses to travel freely from the brain via the spinal column to all body parts. Impeded blood and nerve flow results in pain and disease, if not corrected.

Herbs: Herb medicine and aromatherapy use plants, herbs and other natural substances to stimulate the body to return to the state of health. Though herbs are medicines, they tend to be much safer than chemical drugs for many reasons; they are less potent, more recognizable to the body, and usually used in combinations and potencies that minimize harmful side effects.

Homeopathy: is based on the concept that "Likes cure likes." This means that medication should not be used to counteract symptoms, but to stimulate the body's own healing forces.

Massage and Bodywork: are extremely beneficial for arthritis sufferers. Massage will improve circulation, lymph flow, waste elimination, provide relaxation for sore muscles and joints, and reduce stress and anxiety levels in the body.

There are many different approaches to all things in life; learning to listen to your own intuition will help you find a treatment plan that is right for you. Practicing self-awareness and developing your intuition will guide you on your road back to well being. It usually takes years of wrong living to become ill, it will take some time to become healthy. A Turkish proverb says," No matter how long you have traveled down the wrong road, it is never too late to turn back."

Arthritis is a general condition, which involves the damage of the bones, especially the joints. The joints are places where two bones meet like hands, hips, elbows, or knees. Arthritis causes pain, stiffness, inflammation, and swelling of the joints.

Over time due to wear and tear of the bones and old age, people start to feel stiff, sore and in pain in some parts of their bodies, specially the joints area. People at the age of fifty, and above usually start to complain about these symptoms, and complains about pain and mobility problem. Arthritis is also the leading cause of disability to some people due to the pain and inflammation of the affected area. This disease can last for a long period or recurs, which can lead to tissue damage.

There are different types of arthritis, and according to doctors, there are 100 types of arthritis in the medical book. Here are some of the most common cases of arthritis:

Rheumatoid arthritis - the most common and chronic form of arthritis that usually affects the hands, wrists, and knees. This type is also classified as autoimmune inflammation arthritis. The inflammation spreads around the surrounding tissues and eventually damages the cartilage and the bones. Inflammation is the body's natural reaction if it is afflicted with a disease or injury.

In the case of Rheumatoid arthritis, the defense mechanism of the body is muddled sending wrong signals in the brain and it begins to attack the body instead of healing the injured part. Left untreated this case may shorten the life span of a person who is suffering from arthritis by eighteen years.

Osteoarthritis - this arthritis is usually preconceived to be associated with people who are aging. Well in fact, osteoarthritis is a disease entailing the degradation of the joints. It mainly affects the weight bearing part of the body such the spine, hips, knees, and feet.

While mechanical factors can contribute to the development of osteoarthritis, some people are predisposed to have this disease as part of their genetic make-up. The onset of osteoarthritis takes time to manifest it slowly build up in the body, this is also the reason why many people has mistakenly correlates osteoarthritis as a sign of aging, while in fact it is in the patients body all along. For prevention early diagnosis and check-ups is the key in identifying if you have osteoarthritis.

Gout - is a disorder characterized by sudden recurring attacks of very painful arthritis caused by excessive deposits of monosodium urate crystal in the body, which accumulates in the joints due to abnormally high concentration of uric acid in the blood.

Unfortunately, 20% of people who have gout develop kidney stones. This is because the kidney cannot eliminate these toxins out of the body. Some of the uric acid is a by-product of cellular breakdown, this together with foods adds to the condition.

Juvenile idiopathic arthritis - as the name implies is a common arthritis among children and teenagers under the age of 16. It is a persistent form of arthritis without any definite cause hence, the name idiopathic. In JIA or juvenile idiopathic arthritis, the joints become inflamed. This type of arthritis may be transient in nature or chronic.

There are many types of arthritis, the pain patterns may vary from one person to another, and the occurrence depends on the person's predisposition to the disease itself. This disease should not be a cause to limit you from the things you enjoy or depress you, instead by learning the proper management of the disease, proper diet and exercise, and some lifestyle changes, you can be able to enjoy the things you love the most.

As many as 7.5 million Americans have psoriasis, and they spend between $1.6 billion and $3.2 billion each year to treat the disease of autoimmunity, according to the National Psoriasis Foundation (NPF). Between 150,000 and 260,000 new cases are diagnosed each year, including 20,000 in children younger than 10. Though seldom disabling, the red welts, pustules, and scaling skin that mark the disease can be painful and extremely embarrassing.

A chronic, non-contagious disease, psoriasis [pronounced sore-EYE-ah-sis] varies in its severity and how it responds to treatment. It results from inappropriate responses of the body's immune system to essentially attack the body itself and can occur on any part of the body that's covered by skin. The resulting inflammation can be as mild as something resembling dandruff or as radical as a body covered with thick, crusted plaques. Less than 10 percent of sufferers have an extreme form of the disease; it is a mild form in 65 percent of cases. Everything else is in between mild and serious.

Though it usually doesn't get any worse over time, about 10 percent to 30 percent of people with psoriasis also develop psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints.

Psoriasis is a disease which takes different forms. Among them:Scalp psoriasis

At least half of all people who have psoriasis have it on their scalp. As with psoriasis elsewhere on the body, skin cells grow too quickly and cause red lesions covered with scale. In severe cases of thick, crusted plaques covering the entire scalp, the hair may fall out. The affected area can extend beyond the hairline onto the forehead, the back of the neck and around the ears. Treatments, as with any type of psoriasis, are often combined and rotated because it can become resistant to medications after repeated use. Many treatment options can help control scalp psoriasis and its symptoms:

* Systemic (oral or injected) treatments may be tried if psoriasis is present elsewhere on the body and/or the psoriasis is severe.

Genital psoriasis

Although it usually responds well to various treatments, the sensitive nature of the skin around the genitals requires a cautious approach to genital psoriasis:

* Protopic and Elidel. Both of these drugs reduce skin inflammation much as topical steroids do, but they do not cause thinning of the skin. They may cause some irritation when they are first used, but they do not promote yeast or bacterial growth, which may further help with inflammation and itching.

* Ultraviolet (UV) light. Overexposure to UV light can burn the skin, especially the thinner skin around the genitals, so it is therefore used only in special circumstances and in very low doses.

Psoriasis in the pubic area may respond well to UV light treatment if the pubic hair is cut short or shaved. Men should wear briefs or athletic supporters to protect their genitals while receiving UV light treatment on other parts of the body.

* Dovonex. Though this synthetic form of vitamin D3 has the potential for irritation, it does not have any of the drawbacks of topical steroids, and mixing it with petroleum jelly may minimize irritation.

* Tazorac. Because of its potential for irritation, some doctors alternate its use with a low-strength topical steroid.

* Steroids. Prolonged use of topical steroids can permanently thin the skin and cause stretch marks. Furthermore, psoriasis may become resistant to clearing with continuous long-term use of steroids.

* Over-the-counter (OTC) moisturizers. The skin in affected genital areas should be continuously moisturized, but choose wisely: moisturizers with fragrance and perfumes may irritate.

Facial psoriasis

Areas of the face most often affected are the eyebrows, the skin between the nose and upper lip, the upper forehead, and the hairline. Because other skin diseases resemble the symptoms of psoriasis on the face, a biopsy may be needed to positively identify it.

Rashes may also appear on the eyelids, around the ears, mouth, and on the nose. Treating eyelid inflammation may involve washing the edges of the eyelids and eyelashes with a solution of water and baby shampoo. An over-the-counter product, Ocusoft, can help with removing scales on the lids and eye margins. But a doctor must carefully supervise the treatment because eyelid skin can be easily damaged, and the use of topical steroids there can lead to glaucoma and/or cataracts.

In addition to Dovonex, Tazorac, and ultraviolet light, Protopic may be used in treating facial psoriasis. This and Elidel, both drugs used to treat eczema, have also been found effective in treating psoriasis. Topical steroids may be used, but prolonged use of them may cause enlarged capillaries (spider veins) on the face.

Psoriasis scaling can also block the ear canal and produce temporary hearing loss; it should be removed by a doctor. Psoriasis in and around the mouth or on the lips causes discomfort and may present difficulty in chewing and swallowing food. Improving hygiene and rinsing frequently with a saline solution can help relieve oral discomfort, and there are effective topical steroids that have been designed to treat moist areas.

Psoriasis lesions, usually white or gray, may also appear on the gums, the tongue, inside the cheek, or inside the nose

Friday, August 30, 2013

Osteoarthritis is the most common form of arthritis affecting more than 20 million Americans. It is a disease due to disordered cartilage.

Normal cartilage in the young healthy adult consists of a matrix constructed of a mixture of proteins and sugars (proteoglycans), water, as well as collagen. Within this matrix sit chondrocytes, cells that actually manufacture the matrix they sit in. Picture a bowl of gelatin with grapes sitting inside the gelatin and that is what cartilage looks like.

Under normal situation, cartilage is capable of withstanding both compressive forces as well as shear forces. It deforms when loads are placed on it and then rapidly expands to its normal contour once the load has been removed.

When cartilage is damaged as a result of trauma, injury, or other means, a change occurs in the normal functioning of cartilage. Chondrocytes begin to elaborate destructive enzymes; the underlying bone begins to deform, and the lining of the joint, the synovium, begins to produce cytokines, protein messengers that stimulate inflammation.

The end result is the gradual wearing away of cartilage accompanied by chronic inflammation, and deformity related to abnormal mechanics of the joint.

To date, the treatment of osteoarthritis has been palliative only. Symptomatic relief with non-steroidal anti-inflammatory drugs (NSAIDS), physical therapy, and joint injections of either corticosteroid or hyaluronic acid have been among the measures employed.

The rapid development of stem cell science has provided a glimmer of hope that the treatment of osteoarthritis will also include the ability to restore cartilage integrity.

A caveat: The proper application of stem cells is not merely injecting stem cells into a joint and hoping for the best.

Multiple attempts by various laboratories have searched for a method of introducing stem cells along with a scaffold to enable stem cell propagation in an organized fashion that will best stimulate cartilage regeneration. A whole new branch of basic science, termed "tissue engineering" has been used to describe these ventures.

An excellent review of the current state of the science was published by the Harvard Stem Cell Institute.(Willerth SM, Sakiyama-Elbert SE. Combining stem cells and biomaterial scaffolds for constructing tissues and cell delivery.)

The authors reviewed the literature regarding types of scaffold materials that had been studied.

These included natural biomaterials such as collagen, fibrin, silk, sugars, algae cell walls, hyaluronan, and chitin as well as synthetic platforms such as various polymers, peptides, and ceramics.

These scaffolds are generally "seeded" with growth factors that stimulate stem cell multiplication and division while protecting the stem cells in an undeniably hostile environment, the arthritic joint.

Currently, the use of autologous stem cells in clinical medicine requires the use of fat as a matrix scaffold. When combined with growth factors from blood components, the environment simulates the biomaterial scaffold models described above.

Lumbar spinal stenosis (LSS) is one of the most common maladies seen by rheumatologists. It is a condition that affects the low back. To understand what happens with this condition, it's important to briefly review the anatomy.

The lumbar spine consists of bones, called vertebrae, which are stacked one upon the other and separated by rubbery discs in the front and by joints (called "facet joints") in back. Down the center of this stack is a tunnel where the spinal cord is housed. The column of bones is supported inside and outside the tunnel by a series of ligaments.

LSS occurs when the spinal cord is compressed. There are three abnormalities that are responsible. First, the discs begin to bulge as a result of aging. They dry out and flatten. This leads to disc protrusion into the tunnel where the spinal cord passes. Second, the facet joints develop arthritis and the spurs from these facet joints protrude into the tunnel also. Finally, one of the ligaments that supports the spinal column inside the tunnel begins to hypertrophy and this also protrudes into the tunnel.

The end result is pressure on the spinal cord.

The history and physical examination are usually enough to suspect the diagnosis. Typically a patient older than 70 years will present with low back pain that is aggravated by walking or standing and relieved by sitting or by bending forward.

The pain radiates from the back into the buttocks and sometimes the thighs. Patients will walk with a wide-based gait- legs wider than usual because they feel unstable. This is because the normal signals that are sent from the brain to the feet are not being received so the patient's sense of where they are in space is abnormal.

Severe spinal stenosis is accompanied by bladder problems such as urinary frequency- going to the bathroom much more often than normal.

LSS is often confused for vascular claudication. This is a disorder where the blood flow to the legs is compromised because of narrowing of the arteries. The symptoms are similar. Also, narrowing of the spinal canal in the neck and hip disorders can also mimic lumbar spinal stenosis.

The diagnosis can be confirmed by either magnetic resonance imaging (MRI) or by CT scan of the low back.The natural history of the disorder is one of progression. Conservative measures such as epidural steroid injections and physical therapy can be useful but most patients will require surgery which is often very effective.

You may not know this but there are over 100 different types of Arthritis. It is a condition that affects millions every year, worldwide. As each type of arthritis is different, so must the treatments that are used to help ease the pain and discomfort caused by this condition. Symptoms can be vastly different between each type, so it is vitally important that you see your local GP, so that correct diagnosis can be made and the right treatments can begin.

So what are the most common types of arthritis?

There are two main types of arthritis, Rheumatoid Arthritis and Osteoarthritis. This article will look at both, and explore causes, symptoms and possible treatments. You should however always refer to your GP for help, advice and guidance.

Rheumatoid Arthritis is caused by the malfunction of the body's immune system. This basically means that the immune system attacks parts of the body, for reasons that are not quite clear, the joints are the main areas affected.

Rheumatoid Arthritis is caused when the body's cells confuse one of its own proteins as a foreign intruder. This in return causes the immune system to start attacking the normal joint tissues. As a result there is a release of Cytokines which trigger more inflammation and destruction.

Rheumatoid Arthritis can start gradually or attack very suddenly. Symptoms can be rather severe causing pain, fatigue, loss of appetite, stiffness and fever. Most common symptoms include the pain, stiffness and swelling of the joints affected, which can include hands, wrists, elbows, shoulders, knees, ankles and the neck. Another common symptom is the development of Rheumatoid Nodules, which are lumps that appear on the skin over the affected joint.

In terms of treatments, there are a few drugs that can be administered in order to reduce pain and inflammation. These can be prescribed by your local GP.

The other main type of Arthritis is Osteoarthritis. Osteoarthritis is not as severe as Rheumatoid Arthritis and is a common condition among those over 40. Osteoarthritis is a degenerative joint disease, most commonly caused by the over use of certain joints, and those that bear weight.

Symptoms of Osteoarthritis include deep aching pain within a joint, difficulty gripping objects, fatigue, warm joints, joint stiffness in the morning, pain when walking and the swelling of joints.

Unlike Rheumatoid Arthritis, there are a few Osteoarthritis treatment options. These can be as simple as more exercise and a better healthier diet, pain relief medication and inflammatory drugs to, in more severe cases, Hyaluronic Acid injections straight to the effected joint.

If you think that you may be developing or have developed some form of Arthritis then you must first make an appointment with your local GP. A common mistake is to leave or ignore any symptoms and allow the condition to further develop. Pain and discomfort need not rule your life; there are treatments that can be given to help you maintain your life as normal.

The main difficulty facing arthritis sufferers is that they are told exercise will help but exercise very often increases their pain. Our natural instinct to avoid pain makes us more likely to do less activity, resulting in weaker muscles that don't support our joints.

To break out of this cycle you need to exercise these supporting muscles to make them stronger. The pay-off is less pain but the road is not easily travelled. The most difficult part is getting started. There needs to be a bit of 'trial and error' - gently testing various exercises until you stumble across one that lets you fatigue the muscles without aggravating your knee pain. The best way to do this is to seek the advice of a physical therapist. If the co-pay remains too expensive, there is no reason why you can't have a go yourself. You will need to do your research and find as much information as you can on the subject. There are also some inexpensive books covering this subject.

Why the pool?

Osteoarthritis is primarily a disease of weight-bearing joints. Being in water helps you eliminate or greatly reduce the load on your joints. This allows some exercises to be pain-free in water that would otherwise aggravate you knees.

Purpose built hydrotherapy pools are heated. Heat helps combat stiffness in joints (but remember it can aggravate some inflammatory conditions). The combination of gentle exercise and heat can help lower pain levels. Remember though - just because you don't have access to a heated pool doesn't mean you can't benefit from this type of exercise. Any body of water takes weight off your joints.

The pool also allows you to start very gently. A common reason for people giving up on exercise is that they start too fast, too soon. This causes a flare up and the natural response is "I'm not doing that again......I could not walk for days"

Start in chest high water and walk some laps. If this doesn't bother your knees before or after, add some shallow squats. No two knees are the same so its up to you to learn about your knees and take control of your arthritis.

Rheumatoid arthritis is not just a minor discomfort; this is an actual autoimmune disease that attacks the joints and causes chronic and constant inflammation. This inflammation can also be found in other areas of the body including vital organs. An autoimmune disease is when the bodies own immune system attacks its own systems; in rheumatoid arthritis there are antibodies in the blood that then target their body's own tissues and joints.

Rheumatoid Arthritis is called a collagen disease because it occurs throughout the body's connective tissue. The symptoms vary with the stage of the disorder. At first, those affected complain of fatigue and feeling sore, achy, and stiff. People may eventually find themselves unable to move their limbs fully without trouble because of swelling, inflaming and immobilizing of the joints.

For those who have this disease, it's important to realize that it is progressive but sometimes a patient can go for extended periods of time without any symptoms or attacks. Even though your body may not be experiencing the pain of rheumatoid arthritis you of course still have the disease and need to pay attention to your diet and other lifestyle choices to keep yourself pain-free as much as possible.

It was once thought that there were certain foods that caused or prevented rheumatoid arthritis but more research in this area has proven this notion to be false. Tomatoes do not seem to cause flare-ups and fish oils do not seem to lessen the inflammation either. Once you realize the cause of this condition, that it's an actual disease that cannot be controlled and is not a condition brought on by diet, you can then treat it properly. Many have found that addressing the inflammation of rheumatoid arthritis is best. Taking acetaminophen such as Tylenol helps most patients. Some tetracycline drugs also seem to have the same effect.

Addressing the symptoms of rheumatoid arthritis is also important over and above any medication you may take. Many have found that humidifier in their living and working space is important, as this added moisture keeps the joints fluid and healthy. Proper and regular exercise is also important as this too keeps the body flexible and increases circulation around the joints. However, it's important to choose exercises that don't put any stress on the joints, such as swimming or using an elliptical machine. Running can sometimes make rheumatoid arthritis even worse as the pounding on the feet, ankles, and knees can be very painful.

It may be necessary to make some accommodations for the pain of rheumatoid arthritis and so that the condition is not aggravated. Raised toilet seats are helpful, as are risers under the bed and firmer chairs and couches. Some find that using wrist and finger splints can also cut down on inflammation as well.

Getting recommended physical therapy is also important in keeping the symptoms of rheumatoid arthritis at bay. Follow your doctor's advice and keep yourself active and be sure to do the exercises recommended by your physical therapist and you should be able to manage your symptoms while waiting for a cure.

Some common vitamins and over the counter products may help with the symptoms of rheumatoid arthritis diseases such as:

Vitamin C is essential for defending the body against pollution and infection. It enhances the immune system. Aids in growth and repair of both bone and tissue by helping the body produce collagen. Vitamin C's collagen-producing properties make it a prime candidate for arthritis treatment.

Green Tea Extract contains natural antioxidant compounds known as polyphenols useful in fighting tumors as well as helping prevent and treat rheumatoid arthritis.

Rutin acts synergistically with Vitamin C to help maintain a healthy immune system.

Glucosamine Plus provides cartilage nutrition for healthy joints and is an anit-inflammatory.

Chondroitin Complex works together with Glucosamine to block the action of cartilage-damaging enzymes and promotes the healthy flow of water and nutrients into cartilage-producing cells.

M.S.M maintains the development of the body's protein by forming flexible disulfide bonds between certain amino acids and in maintaining the strength of connective tissue.

Always consult your doctor before using this information.

This Article is nutritional in nature and not to be construed as medical advice.

This book asserts that there is such a thing as a drug-free cure for arthritis and fibromyalgia. This is not just pain reduction, but elimination.

According to the author (and new medical research), the cause of arthritis is due to infection, either viral or bacterial. The first place to look for a cause, especially if you have had a root canal. It is very hard to clean all of the bacteria out of a diseased tooth, so if the root canal was done improperly, it is very possible that some of that bad bacteria will enter your bloodstream through a cut or scrape in your mouth. The bacteria will travel to someplace safe, where there is little blood nearby, like a bone joint. That is why the usual drugs have little, or no, effect, as the bacteria eats away at your cartilage.

So what is the answer? Coconut oil. Teeth are very porous, full of tiny tubules, where the bacteria can hide. Brushing and flossing won't clean out those tubules, but coconut oil will. The book goes into detail about why coconut oil is so healthy. Take a teaspoon or two, and swish it around your mouth for several minutes. Don't gargle, and don't swallow (spit it out when you are done). You don't want to draw all those toxins out of your mouth, and deposit them in your stomach. Coconut oil can be also used in cooking, and taken internally as a dietary supplement. Do it everyday, and, after a couple of weeks, even the most extreme cases will show improvement.

Is that the whole story? No. After cleaning out your system, change your diet by a lot. Everybody says that, but consider this: After going to all that trouble, and eating all that coconut oil, to clean the arthritis infection out of your body, do you really want to let it back in with an unhealthy diet? Think about taking a combination of glucosamine and chondroitin to rebuild those damaged joints. Exercise will help limber up your joints, so get moving. If the pain has limited your mobility, start with something you can do (even simply standing and bouncing on one of those mini-trampolines). If you are overweight, lose some of it. Every pound lost decreases the stress on your joints.

You're thinking: Not Another Miracle Cure, right? If the best the medical profession can do is to hand you a bottle of painkillers and tell you to live with the pain, or schedule you for a joint replacement operation, what have you got to lose? This method is easy and drug-free. This book is full of success stories, and is extremely highly recommended.

Thursday, August 29, 2013

As a personal trainer who specializes in helping older adults and seniors maintain and create more independent lifestyles, nothing draws attention more than watching someone "plop" down into a chair, because the intention to move with purpose is lost. To me, this is a clear indication that someone has already taken the first step of muscular deterioration leading down the "slippery slope" towards an unnecessary fall.

Certified as a Senior Populations Specialist through the National Academy of Sports Medicine, my fitness training has shown me that older adults with osteoarthritis experience tremendous lifestyle benefits by performing purposeful exercises just one-two times per week. That is good news, because for folks who don't list exercise as a favorite pastime, starting a fitness program after retirement is a challenge, even when the benefits are well understood.

In fact, the Center for Disease Control reports only six percent of adults over age 64 meet the national objectives for physical activity and strength training!

And the facts about the risk of falling are strikingly clear...

Osteoarthritis affects approximately 49% of seniors over 65 years of age (National Academy of Sports Medicine) and often impacts an individual's strength and sense of balance. Compound that with normal muscle atrophy which occurs every year after age 30, and it's not surprising that the Center for Disease Control states that falls among older adults are the most common cause for injury and trauma-related hospital admissions.

Hire a personal trainer?

While you might choose to hire a professional fitness trainer to help you exercise safely and keep you motivated, there are simple things you can do at home to improve balance, leg strength, and core stability. With targeted exercises to address these three key areas, you'll see strength and balance improvements in a matter of weeks, reducing the chances of a fall.

At my personal training studio, clients with osteoarthritis understand that, even though some joint discomfort may be present during weight lifting and cardio based activity. By contrast, sedentary individuals typically experience more rapid deterioration in cartilage and joint health. This is because cartilage is very avascular (has few blood vessels) and the corresponding lack of blood supply means that the only way to nourish the cartilage is to force nutrients into the joint/cartilage through movement.

Simple exercises can help keep your joints healthy and muscles strong

(*Always consult your physician prior to starting any new exercise program and seek professional guidance to adapt the following exercises to match your fitness level and adapt to restrictions given to you by your doctor).

1) Standing Squat:

Start with your feet hip to shoulder width apart. With (or without) dumbbells held by your side, sit down into a chair and stand up, without gaining momentum on the way up, or plopping on the way down. Keep your knees tracking straight ahead over your toes. Raise or lower your seat to adjust for fitness level.

2) Balance Reach:

Standing on 2 feet hip width apart, reach both arms forward as far as possible, bending only at the hip, and keeping your back flat. Try this standing on one foot if two feet is too easy.

3) Elevated Push up:

Place your hands shoulder width apart on a counter top or the arm of a sofa. While squeezing your butt muscles together and keeping the abdominals braced (as if prepared to be punched in the belly), keep your body as straight as possible. Lower your entire body down in one segment using only your arms. Do not let your back arch or your belly sag. Move slowly through each repetition and find a height that matches your ability.

4) Walking Stairs:

In your house, as you walk up the stairs, consciously try to squeeze the glute (butt muscle) with every step. Drive through the heel and stand up tall.

5) Curl Up:

Laying on your back in bed, do your best to sit up straight, reaching your hands toward your toes. Try to avoid placing your hands down on the bed, unless you need the assist.

6) Hand Walk:

Standing with feet shoulder width apart, place your hands on the ground or elevated surface, allowing the knees to bend if necessary. Walk your hands out toward a push up position, then walk your hands back toward your feet and stand up tall. This is a great technique for getting up or down to the floor for folks with really bad knee pain, but reasonable upper body strength and healthy wrists.

Each of the above exercises should be done in a way that challenges you to perform 12-15 repetitions. If you can do more, it's too easy! If you can't get to 12 reps, the exercise is too hard and you increase your risk for injury.

Strength & balance training in addition to proper nutrition are all critical for fall reduction and injury prevention.

Erosive arthritis affects multiple small joints of the hand. Patients who have never had a trauma or injury and do not have any history of metabolic or inflammatory condition are the ones who are diagnosed with erosive osteoarthritis which is classified as primary osteoarthritis. X-ray of the affected joint is the most effective test for the diagnosis of this condition.

Erosive osteoarthritis is the most prevalent form of osteoarthritis. Though the disease is not uncommon in men and women, but particularly people in their sixties are the most susceptible to this condition. It is believed that it often occurs mostly due to genetic traits. It usually occurs in women after their menopause but no clear relation with the level of hormones in the patient and the onset of the disease has been established as yet.

In the early stages of the disease, the treatment usually aims at reducing the enormous amount of pain caused by the various conditions brought forth by the disease. Attempts are also made towards reducing the load felt by the joints. Using walking sticks and weight loss programs are common methods for doing the same. Mobilization of the joints, through prescribed exercises is also a part of the treatment at this stage.

In the intermediate stage of the disease is osteotomy, which is a surgical operation where a bone is cut to lengthen, shorten or change its alignment. This operation is usually performed for younger patients.

In the later stages of the disease, the incessant pain requires drastic methods of treatment. In such a case, Arthroplasty is performed on patients over the age of 60. It is a surgical process in which a malformed or degenerated bone is either replaced or reconstructed. However, this operation is not suitable for treatment of younger patients as the demands placed on the affected bones physically are much greater and many a times, the surgery is only a temporary remedy.

Arthritis is a growing disease in this country (over 41 million Americans are afflicted), and many rely on drugs and surgery as a cure. The disease, arthritis, covers actually over 100 rheumatic diseases (inflation of the joints). The two most common forms are osteoarthritis (cartilage deterioration of the hand and foot), and rheumatoid arthritis (the auto-immune system breaks down causing inflammation of the joints).

Arthritis differs from other diseases in that it is not always chronic; it could flare up some days and remain subdued on others. Flare-ups are generally related to weather conditions, such as barometric pressure and cold temperatures.

If you suffer from arthritis, it is generally recommended that you avoid the following: "nightshade" vegetables (vegetables that grow at night, not during the day), such as potatoes, eggplant, peppers, and tomatoes; tobacco; coffee; caffeinated tea; salt; artificial colors; and preservatives.

Conventional medical theory says there is no cure for arthritis; only treatments to reduce the pain and inflammation (such as aspirin, ibuprofen, and a supplement called glucosamine). These provide short-term relief, but create long-term problems such as deterioration of the liver and stomach.

There are surgical procedures available including joint replacement. But these should represent the last resort. Any surgical procedure is a high risk approach, which could result is less than optimal outcomes.

Of growing interest amongst homeopathic doctors is the consumption of juices from certain fruits and vegetables. (See "Natural Physicians Healing Therapies" by Mark Stengler). Juices which contain phytonutrients help the body to regenerate cells, especially around joints. Vitamin C is also helpful, since it contains an antioxidant, which aids in the reduction of inflammation and swelling of the joints.

A List of Fruits and Vegetables

The following is a partial list of fruits and vegetables that could alleviate the symptoms of arthritis.

A daily diet of juices (fruit and vegetable) will help prevent arthritis. As the saying goes: "An ounce of prevention is worth a pound of cure."

An excellent juicer is the Sharper Image Super Juicer. It is easy to use, easy to clean, high quality (700 watt motor), and very efficient juice extraction. This juicer is priced under $100, and is an excellent choice towards living a healthy life through juicing.

The approach to treating inflammatory forms of arthritis depends on several factors. These include the type of arthritis, the experience of the practitioner, the age of the patient, potential confounding factors such as allergies, length of time the patient has had the arthritis, previous drugs tried, and whether the drugs are to be used one at a time or "layered" on top of each other.

For example, a disease like rheumatoid arthritis demands aggressive treatment with a disease modifying anti-rheumatic drug (DMARD) such as methotrexate. Methotrexate tends to work well to slow disease. However, initiation of methotrexate is just the first step. This is quickly followed by either the addition of a biologic medicine or by adding other DMARDs.

In contrast, a disease like psoriatic arthritis may or may not respond to methotrexate. So a different disease modifying anti-rheumatic drug is required. And that's where a medicine like sulfasalazine has utility.

Sulfasalazine was manufactured originally by combining an antibiotic, sulfapyridine, with an anti-inflammatory drug 5-aminosalicylic acid. The latter, as the reader might surmise, is a form of aspirin.

This was done because many years ago it was felt that rheumatoid arthritis was an infectious disease so an antibiotic coupled with an anti-inflammatory drug made sense as a drug that would be useful to treat rheumatoid arthritis. And, it has been shown in a number of studies to be effective in rheumatoid arthritis acting as a DMARD. Its effects are relatively mild.

It is an oral drug taken daily. Roughly one-third of sulfasalazine is absorbed from the gut. The remainder is broken down into its component chemicals, sulfapyridine and 5-aminosalicylic acid. Sulfapyridine is absorbed from the gastrointestinal tract and the 5-aminosalicyclic acid is excreted.

Sulfasalazine (trade name, Azulfidine) has immunomodulatory effects on cells that propagate inflammation. Often sulfasalazine is combined with biologic therapy or it is sometimes combined with methotrexate and hydroxychloroquine (Plaquenil) or azathioprine (Imuran) in patients with rheumatoid arthritis. The exact use generally depends on the experience of the practitioner.

Where it seems to be more effective is in the other inflammatory forms of arthritis such as psoriatic arthritis, ankylosing spondylitis, and certain forms of juvenile arthritis. Why this is, no one knows.

My name is Barbara Allan. In 1988, at the age of 25 I suddenly developed arthritis. This was 6 weeks after contracting Shigella food poisoning while camping during a vacation in Michigan.

The type of arthritis I was diagnosed with is reactive arthritis, since it was in reaction to a Shigella infection. (Shigella is a bacteria, similar to Salmonella, that cause bacterial dysentery, which is what I had.) Many types of bacteria can trigger reactive arthritis. They include Yersinia, Chlamydia, Salmonella, and Shigella.

Reactive arthritis is also known as Reiter's Syndrome. There is an unfortunate stigma attached to the name Reiter's Syndrome because that name is strongly associated with arthritis caused by bacterial infections in the genital area, in other words, venereal diseases. I say unfortunate stigma because it can interfere with being treated with proper respect by the medical community.

I assume this is because the idea of self or others being sexual brings up unresolved feelings for many people, and the name Reiter's Syndrome immediately stirs up those issues. However, regardless of exactly why, I've found that I have been treated better within the health care system when I have used the name reactive arthritis instead of Reiter's syndrome, even though they are the same condition.

Although my reactive arthritis was painful for me, my doctors initially didn't worry very much about it, because reactive arthritis will often times go away on its own once the infection is gone. So I waited a month, but no improvement. I waited six months, and still no improvement.

My doctor then started getting angry at me, because I wasn't getting well. She even refused to continue treating me and accused me of being a slacker. After another year, my next doctor also gave up on me.

So I turned to alternative medicine. Turns out I was having an allergic reaction to the starch that was used as an "inert ingredient" in the prescription medication I was being given to calm the inflammation in my joints. The pills I was being prescribed were keeping me sick.

I was also having an allergic reaction to several other foods. This is because the dysentery and then the arthritis drugs I was given were so hard on my digestive tract that I started leaking small bits of food into my blood stream, where my immune system started attacking them. I had certainly never had food allergies before this time.

Once I cut my problem foods out of my diet, my arthritis went away and my digestive tract healed up.

Turns out that this is a problem not only with reactive arthritis, but also with rheumatoid arthritis. In fact, I got the idea from looking at what helps cure rheumatoid arthritis.

I've learned a lot about healing arthritis from healing myself and helping others do the same. I've you would like my help (My name again is Barbara Allan.) then check out my services.

Arthritis is a complex disorder that comprises more than 100 distinct conditions and can affect people at any stage of life. Two of the most common forms are osteoarthritis and rheumatoid arthritis. These two forms have very different causes, risk factors, and effects on the body. The most common symptom in both is persistent joint pain. The joint pain of arthritis can appear as hip pain, knee pain, hand pain, or wrist pain, as well as joint pain in other areas of the body.

For most people arthritis pain and inflammation cannot be avoided as the body ages. Joints naturally degenerate over time. Fortunately, arthritis can be managed through a combination of vitamins, medication, exercise, rest, weight-management, nutrition, and, in some cases, surgery. Arthritis is a chronic disease that will be with you for a long time and possibly for the rest of your life. Your treatments will probably change over time and medication may be adjusted. Having a positive mental outlook and the support of family and friends will help you live with arthritis and be able to continue to perform your daily activities.

Before going any further, it is important that you remember to discuss any and all vitamins and supplements with your doctor before adding anything to your diet. Though it is not common, some vitamins and supplements can have adverse reactions with medications you may already be taking. Do not stop taking any prescribed medications without first talking to your doctor.

As an alternative to getting your RDA through diet, many people now take vitamin supplements. The following list of vitamins are known to be especially beneficial to arthritis sufferers:

Vitamin B5 - When grouped together B vitamins work at their peak, B5 specifically being good for reducing swelling.

Vitamin B3 - This vitamin reduces tissue swelling and dilates small arteries, improved grip strength and joint mobility and increasing blood flow. Note that Vitamin B3 is NOT advised for persons with high blood pressure, gout or sliver disorders.

Vitamin B6 - Another B that reduces tissue swelling. B-6 shrinks the synovial membranes that line the weight-bearing surfaces of the joints. It thus helps to control pain and to restore mobility in the elbows, shoulders, knees and other joints.

Vitamin C - This vitamin acts as an anti-inflammatory, relieving pain, and rids the body of free radicals. In addition to reducing inflammation, vitamin C also helps form collagen, the protein "glue" that holds cells together. Collagen is especially important in connective tissue to insure healthy ligaments, cartilage, tendons and the joints themselves.

Vitamin E - This is a strong antioxidant that protects joints from free radicals while increases joint flexibility.

Vitamin K - This vitamin assists with mineral deposit into the bone matrix.

Selenium and Zinc- The antioxidant nutrients such as selenium and zinc might also be effective because of their ability to stop free radical damage to joint linings that in turn causes the accumulation of fluids, swelling and associated pain.

Chondroitin - the key structural component in cartilage and plays an important role in the maintenance of joint cartilage.

These guidelines will help you evaluate supplements to relieve arthritis symptoms. If used under the guidance of your physician, you may find a dietary supplement to compliment your current arthritis therapy regimen. You just need the right information to help you separate potentially useful supplements from the rest.

Our knees take a considerable amount of punishment during our lifetimes. The knee is involved in every step we take and the constant pounding can take its toll. Arthritic knees are not uncommon, In fact, if you have been active over the years in sports or just day to day living, there will be some internal micro damage resulting in arthritis which is commonly called osteoarthritis.

Knee osteoarthritis of course is a major problem in the 21 st century due to the fact that we as individuals are heavier. In turn the heavier you are the more force that is driven through the knee with every step you take. To help keep your knees as mobile and as pain free as possible, there are a number of different exercises you can do to help strengthen the knee. The stronger the muscles are that surround the arthritic knee, the longer you can use them and stay active with less pain. Stronger muscles surrounding the knee act like a buffer preventing the knee joint itself from absorbing more punishment then is required.

The following exercises are considered appropriate to help strengthen your arthritic knees,

1. Stationary biking. Biking is a wonderful exercise that not only promotes blood flow around the knee capsule itself but, promotes more range of motion that will help with overall mobility and stamina. Biking whether it is stationary or mobile, is also a great exercise to keep your quadriceps and hamstrings strong. Biking may be considered the best exercise for your knees that you can do.

2. Water Therapy. Water or pool therapy is good at reducing the impact of our bodyweight while completing exercise. Your bodyweight decreases the deeper you are in water therefore, exercise in a pool is more comfortable for many individuals that have arthritis that has progressed to the point that, walking on land has become so painful that their mobility has declined. In water, you have complete control over the amount of resistance you provide your knees by the speed of movement in which you complete the exercises.

3. Weight Training. There are three main exercises that are effective in strengthening the arthritic knee without driving extreme forces through the knee joint itself. Seated leg extensions whether you do them at home with several pounds or, go to a gym in use more sophisticated equipment, this exercise builds strength in the quadriceps which help absorb the shock of your bodyweight each time you take a step.

Hamstring Curls are another exercise that helps build muscle strength and balance within the knee joint also. Weak hamstrings and strong quadriceps will add additional discomfort to the arthritic knee by having unequal forces working against each other applying more stress in the knee. The quadriceps generally are always stronger than the hamstring group as a whole so, having weaker than normal hamstrings does not help the knee joint.

Calve Raises. This is another exercise that can be done effectively in your home or in the gym. This exercise helps build and strengthen the calf muscles which also play a part in protecting the arthritic knee. This exercise can be done without driving excessive force through the knee causing more pain. Strong calves help absorb impact each time we step as well, therefore stronger calves act like a buffer between the surface and the knee joint from below.

This is a sample of the main exercises that are available to a knee where arthritis has advanced to the point that care has to be taken in prolonging the knee and, reducing pain. Your choice of exercises of course will depend on your age, how far advanced the osteoarthritis is and, your overall medical condition. when it comes to an arthritic knee, exercise is highly recommended by both orthopedic surgeons and physical therapists.

Maintaining an exercise program for your knees will help maintain strength and mobility which arthritis is always trying to take away if allowed to go unchecked.

Wednesday, August 28, 2013

Fish oil supplements for osteoarthritis can be very beneficial for alleviating the symptoms and providing excellent pain relief. In fact, many brands go as far as claiming it as "natural cure for osteoarthritis". Find out the expert facts in this article to make the best health decision.

Due to the various side effects of prescription based drugs for combating inflammation and pain relief, people are looking for natural cure for osteoarthritis. Fish oil supplements for osteoarthritis are among the topmost choice due to their numerous health benefits on overall health.

Fish oil is rich in omega-3 fatty acids. They have excellent natural anti-inflammatory properties and also play a key role in improving brain and cardiovascular health. Research has shown that they help to reduce tenderness in joints, reduce inflammation, decrease morning stiffness and reduce the amount of medication required for controlling inflammation for people suffering from rheumatoid arthritis.

They also play a key role in reducing the activity of the enzymes that destroy cartilage in joints. Green lipped mussel that is found in New Zealand is also an excellent source of omega-3 fatty acids. It has great anti-inflammatory properties and helps in reducing pain and joint stiffness, improving grip strength and enhancing joint mobility in osteoarthritis patients.

A special consideration while looking for fish oil supplement for osteoarthritis is that you should avoid supplements that are rich in vitamin A - such as cod liver oil and those derived from fish liver. This is because vitamin A is toxic when consumed in large doses from animal sources. Beta-carotene is a much safer choice when it comes to vitamin A supplementation.

Adults should consume around 1000 mg of Omega 3 fatty acids on a daily basis. While looking for fish oil supplement for osteoarthritis, make sure that it is "pharmaceutical grade" or molecularly distilled. Molecular distillation is a process that separates toxins and contaminants such as mercury, lead, PCBs, etc. from the fish oil and the resultant oil is then encapsulated into supplements.

This is essential to ensure maximum product safety and effectiveness. It also guarantees that you do not consume harmful toxins that are generally found while consuming fish directly.

Although it might not be a natural cure for osteoarthritis, using fish oil supplements for osteoarthritis in combination with green lipped mussel extract of New Zealand is one of the most effective natural alternatives for achieving relief from inflammation and pain, as well as protecting the joint cartilage from additional damage.

Ankylosing spondylitis is an inflammatory arthritic disease or spondyloarthropathy, classified with reactive arthritis, bowel disease arthritis and psoriatic arthritis. The underlying relationships between these diseases are complex but they are connected by enthesitis (inflammation of the ligament/bone junctions) and by possession of the HLA B27 gene on white blood cells. The enthesitis process at the joint edges can cause fibrosis and then ossification of the area (bone formation).

The frequency of the HLA B27 gene in the population determines the number of people with Ankylosing spondylitis, the most common disease in the spondyloarthropathy group. AS occurs in about 0.1 to 1.0% of people, being much more common in northern Europe and much less common in equatorial regions and with white people more frequently affected. 100 people may possess the HLA B27 gene but only one or two of them will develop AS unless they have a closely related person with it, in which case their risk rises to 15 or 20%.

Only one female is diagnosed with AS for every three males, and female patients' symptoms are often much milder and some may be missed as a diagnosis of AS. The most typical presenting group is young men under 40 years old, with under sixteen year olds making up to twenty percent of this group. The symptoms appear on average at twenty-five years of age and the diagnosis is rarely made above fifty years old. AS can look like mechanical back pain if sufficient attention to detail is not made. Strong and persistent stiffness is often an answer to the question of how they are in the morning.

Ankylosing spondylitis has similarities but distinct differences from the much more common low back pain:

Morning stiffness in the lumbar spine, lasting at least 30 minutes or longer Exercise improves the back pain and stiffness Rest worsens the pain and stiffness Pain is usually worse in the second half of the night, after a time of rest Peripheral joints are affected in 30 to 50% of patients Tiredness is common AS has systemic affects from its inflammatory nature which can include feeling unwell, fever and loss of weight.

Physiotherapy examination of the spine in an AS patient usually uncovers significantly reduced ranges of spinal movement from normal, with perhaps a reduced lumbar lordosis and an increased thoracic curve. Neck movements may also be limited in later stages and a reduction in chest expansion noted due to rib joint involvement. Peripheral symptoms occur in around a third of patients and the physio will palpate the tender areas, searching for evidence of enthesitis in the insertions of the Achilles tendon and plantar ligament of the foot. These are areas of high mechanical stress and commonly affected.

Postural analysis of the AS patient is the first thing a physiotherapist notes after the subjective examination, recording spinal abnormalities, flexed knees, rounded shoulders or poking head posture. The ranges of movement of the cervical, thoracic and lumbar spine are measured and a battery of standard measures taken which allows assessment of the disease progression. The hips or other peripheral joints may be affected and these need to be measured also, with the physio likely testing out sites where the enthesis is likely to be painful and inflamed. If the disease is active then the patient may also have joint effusions and may appear unwell, be sweating and not have slept well.

Initially a physiotherapist might treat an active, inflamed site such as the tendo Achilles insertion using ultrasound, ice and gentle stretching, with foot problems responding to insole use. Whole spine exercises are taught with encouragement to get to the end of the movements, concentrating on antigravity movements including extension of the lumbar and thoracic spine, rotation of the thorax and neck retraction and rotations. To counter the typical spinal deformities, patients are taught to rest in good positions such as flat on a firm surface with only one pillow and lying prone. Pool therapy is very popular and effective and patient education is vital to maintain therapy over time.

Arthritis is often considered as a single condition. The fact is that arthritis is the name given to a set of conditions which leads to swelling up (or more technically inflammation) of the joints of the body. There are over a hundred rheumatic conditions and a few other non-rheumatic conditions which are collectively known as arthritis.

It is likely to affect people who are involved in physical or manual labor. Due to the wear and tear of the various joints in the body one could develop arthritis. This is more commonly known as Osteoarthritis. This affects hips, hands, knees and spine leading to chronic pain. One other important variant of arthritis is rheumatoid arthritis. It is similar to some of the autoimmune diseases like lupus. The body starts attacking the cells that are present in the joints mistaking them for foreign agents!

Arthritis in theory can affect people of all ages. The statistics suggest that people above the age of 50 have a high likelihood of getting this disease. Early detection of arthritis is absolutely necessary as they could lead to debilitating and fatal medical conditions, if left untreated.

It is not difficult to identify arthritis early. Symptoms usually include fatigue, joint pain, muscle stiffness and weight loss. But these symptoms could be indicators of other medical conditions as well. A combination of these issues usually warrants a check up with your physician who is likely to identify an arthritis condition easily.

It is very important to understand that arthritis is neither fatal by itself nor curable completely. The first thing that you should do if you have arthritis is to understand your limitations and adjust your lifestyle accordingly. You should be ready to acclimatize yourself to chronic pain!

There are a lot of medications for reducing pain. Biological response modifiers, non steroid pain killers, selective inhibitors and glucocorticoids are some of the options. Almost all of these medications involve deadening or inhibiting the transmission of pain impulses. But there have been a lot of concerns raised over the side effects of these drugs. They are said to cause increased vulnerability to heart diseases at a later stage.

As an alternative to medicine you could try out some exercises with chiropractors. Some even like to resort to topical medicines like balms which greatly help to alleviate the pain by a substantial degree. Most of these medicines contain glucosamine and chondortin, both of which are used by the body to create cartilages which are the most important part of joints. The wear and tear faced by joints cause pain. If these two drugs are used they help to repair the torn cartilages making your joints healthy!

Anyone living with a chronic condition such as osteoarthritis of the knee should keep an eye on developments in the field. Knee braces are one treatment that has been progressing in recent years. In the past, knee supports, such as generic neoprene sleeves, were all that was available. These provided a small amount of assistance to the knee and kept it warm. Thankfully we have moved on from then.

There is a new category of product that can have significant benefits for osteoarthritis sufferers. Offloading braces can dramatically reduce pain and increase activity levels - but they are not suitable for everyone.

In order to benefit from these braces you need to have osteoarthritis in half of the knee only. Unicompartmental osteoarthritis occurs when the damage is restricted to one area, either the inside or outside of the knee. In this situation all of the body's weight is taken through the affected half of the knee causing an increased rate of wear and increased pain. These braces work by changing the angle at the knee, redistributing the body's weight so it is evenly shared between the inside and outside. This removes the focal point from the painful side.

By the unaffected side doing its share of the work, pain is reduced and mobility increases. It should be noted however, that the brace does not treat the affected side which remains worn. The only thing that will make that area 'unworn'is joint replacement surgery.

There are many braces on the market claiming to offload the knee but it should be noted that a study by The Journal of Bone and Joint Surgery found that only 2 braces physically offloaded the joint. These were the OAdjuster by Donjoy and the Thruster by Bledsoe. If you think you may benefit from this type of bracing, speak to a Physical Therapist.

In the United States an estimated 2.1 million people have been diagnosed with Rheumatoid Arthritis, a chronic condition which causes the body's immune system to attack healthy joints. This auto immune disease brings about painful inflammation in the lining of joint tissue but it can also attack other areas of the body such as the heart, lungs, eyes and blood vessels. Permanent damage and disfigurement is inevitable if the disease is left untreated.

The first step in treatment and prevention of impairment is to understand and identify the signs and symptoms of rheumatoid arthritis. Sore, stiff joints in the hands, knees, elbows and feet are common, and are symmetric which means it will happen on both sides of the body. Morning stiffness that last for 30 minutes or more, fatigue, aching and/or flu like feelings, swelling or redness of joints are likely symptoms of Rheumatoid Arthritis.

If one or more these symptoms occur a doctor's appointment should be made as soon as possible for true diagnosis. Blood tests are taken to screen for the Rheumatoid factor, the autoantibody which turns the immune system against its own tissues. X rays may be done in order for the doctor to have a complete prospective of possible joint damage. A rheumatologist, a rheumatoid arthritis specialist who is able to give specific input, should be involved in the patients further health care.

There are new procedures and treatments for symptoms of rheumatoid arthritis more and more each year. The earlier a patient is diagnosed the more chances of preventing joint damage, putting the disease into remission, and carrying on an active, normal life.

Arthritis which literally means inflammation of the joints refers to at least 100 different rheumatic diseases. It is one of the most chronic diseases of the nation. Rheumatoid arthritis is a major form of this medical condition which has an unknown etiology. It is characterized by inflammation of the lining of the synovial joints which often results in severe joint destruction. The peripheral joints are most often affected especially those in the hands.

Most patients initially experience morning stiffness which is a mobility problem just like what is felt when hit with zap stun guns. fatigue, weight loss, fever, and muscle wasting. On physical assessment, joints are warm, tender and swollen. Movement is guarded and range of motion is decreased. Characteristically, joint involvement is bilateral and polyarticular, with the hand most often affected. The thoracic spine and lumbar spine are rarely involved.

Extra-articular manifestations include anemia and rheumatoid nodules. The nodules are painless, movable, and skin-colored. They are located over the elbows, extensor arm surfaces, knees, knuckles and heels. Synovial cysts and carpal tunnel syndrome are other manifestations. In later stages of rheumatoid arthritis, characteristic deformity, such as lateral deviation of the joints in the hands become obvious. Ulnar deviation is also present in which the hands turn outward toward the ulna and the fingers are flexed and turned laterally at the metacarpophlangeal joints.

The diagnostic studies for this kind of condition are shown in X-rays wherein during the early stages periarticular soft tissue swelling and osteoporosis are revealed. As the disease progresses, X-rays reveal narrowing of joint spaces and ankylosis. Various laboratory tests that are helpful include ESR and rheumatoid factor.

There is no cure for rheumatoid arthritis however it can be managed. The management objectives are reduction of inflammation and pain to preserve joint motion, maintain muscle strength, and prevent secondary stiffness and deformity. The basic medical management includes rest, exercise, heat or cold therapy, splinting, positioning, drug therapy, a well-balanced diet, correction of anemia, and removal of sources of infection. When conservative therapy is ineffective, surgical intervention to restore function may include arthroplasty or joint replacement.

Each patient must be assessed to determine the extent of the disease and the implications for the needs of the person affected to plan the care. Psychological support is provided to the patient since many of them undergo a period of denial or grieving over loss of full mobility. Encouraging care of the self and concentrating on what the patient can do help to prevent a negative self image.

If you or someone in your household is experiencing this kind of health problem, it is better to seek for prompt management so that the pain of arthritis will not be felt at a full blast. The pain is more like stun gun effects on the body and you would not want to experience this kind of feeling. With proper management and knowledge of the clinical condition, you can prevent any painful attacks with the help of medications and you can take care of yourself at home.

Tuesday, August 27, 2013

Many of the aches and pains involved with the aging process are due to osteoarthritis or degenerative diseases of the bone. As we age our bones, joints, and the cartilage which holds them together begin to go through changes.

New Chapter know that degenerative arthritis also known as degenerative joint disease is part of a group of related diseases and/or mechanical abnormalities which relate to the degradation of our joints. This is why we feel stiffness, creaking, tenderness, joint pain, and sometimes locking of our joints. Many times this is the result of locally inflamed joints and connective cartilage, known as osteoarthritis (OA).

A loss of cartilage is the result in many instances, creating pain on movement. When this tissue is damaged, it tries to re-grow itself and this often accelerates the damage. Cartilage is made up of a strong protein matrix which lubricates while it cushions our joints. As this breaks down, our joints no longer "glide" in place as when we were younger, and each movement becomes painful.

New Chapter Vitamins, minerals, and supplements have much to offer those who suffer from osteoarthritis through their calcium supplements, which are derived from whole food sources. And when calcium is paired with natural co-factors like magnesium along with other trace minerals, works most effectively to strengthen bones and joints suffering from diseases like osteoarthritis.

New Chapter calcium complex proudly delivers key essential nutrients, derived from whole food (the safest, most active form). Our bodies need this form of nutrient complex, knowing it works much more efficiently than the limestone sources to be found in many other calcium supplements.

Other essential ingredients

Among other essential ingredients found in New Chapter Vitamins, supplements, and minerals are calcium and magnesium supplements, along with other bone enriching nutrients to complete the food complex. Vitamin K has been found to be an essential co-factor useful in calcium absorption as well as calcium retention in our bodies. When human cell proteins don't get enough vitamin K, they do not tend to hold on to the calcium in the body and the results are loss of vital nutrients.

The elbow is primarily a hinged joint, capable if bending and extending. It also has a rotation component as well. The joint is held in place with a complex arrangements of ligaments and surrounded by multiple nerves, muscles, and blood vessels. The elbow also has an intimate association with the wrist and hand since the muscles that govern wrist and hand movement have their origin at the elbow.

The two major muscle groups that permit movement of the wrist and hand are the flexors (help the hand make a fist and help the wrist to bend downward) and the extensors (help the fingers to extend and the wrist to bend upward).

The flexors have their origin at the medial epicondyle (inside bony protuberance) and extensors have their origin at the lateral epicondyle (outside bony protuberance). The muscle origin attachment for the flexor muscle group is called the common flexor origin and the muscle origin attachment for the extensor muscle group is called the common extensor origin.

This article will discuss lateral epicondylitis- a disorder that occurs at the outside of the elbow.

Lateral epicondylitis (LE) is a common disorder that is often referred to as "tennis elbow." Interestingly, most people who develop this affliction don't play tennis. Overuse is probably the most common cause, but sometimes minor trauma also plays a role. Many people say, it just began with no history of antecedent overuse or trauma. Gardeners are particularly at risk.

Pain is located directly at the lateral epicondyle or perhaps a bit more distal. The discomfort is aggravated by such activities as shaking hands, lifting a bag, or even getting milk out of the refrigerator.

The "itis" suffix indicates that inflammation plays a prominent role. However, most people, particularly those in their 30's or older do not have inflammation as the underlying problem. Rather, what is seen is tendon degeneration involving the common extensor tendon group. The most common tendon affected is what is called the extensor carpi radialis brevis.

Treatment of the disorder is straightforward. Rest, limitation of the activities, and symptomatic relief are the treatments which are usually used first. Ice, moist heat, and either analgesics or non-steroidal anti-inflammatory drugs (NSAIDS) to help with pain sometimes are helpful. The NSAIDS are used for their analgesic properties, not their anti-inflammatory properties per se.

A "tennis elbow" brace, specific stretching exercises, ultrasound administered by a physical therapist, and a single localized ultrasound guided steroid injection can sometimes provide relief. The steroid injection is problematic because local inflammation is not the issue and the steroid can further weaken the already degenerated tendon.

An MRI can also determine if there is a small tear present if the patient doesn't get better. Entrapment of the radial nerve (radial tunnel syndrome), and tendinopathy of the distal biceps tendon can both mimic LE.

Patients who don't respond to conservative measures usually will improve with ultrasound-guided percutaneous needle tenotomy accompanied by platelet-rich plasma (PRP). PRP is a concentrate of a patient's blood which contains a large number of platelets, cells that have many growth and healing factors. This procedure actually builds new tendon tissue and is considered the procedure of choice now for severe chronic LE.